We need you! See something you could improve? Make an edit and help improve WikSM for everyone.
Joggers Foot
From WikiSM
Contents
Other Names
- Medial Plantar Neuropraxia
- Joggers Foot
- Transient neuropraxia
- Medial plantar nerve (MPN) impingement
Background
- This page refers to neuropraxia of the Medial Plantar Nerve (MPN) seen in runners, commonly termed 'Joggers Foot'
History
Epidemiology
- Rare and poorly described in the literature
Pathophysiology
A) Anatomy of the medial plantar nerve. B) Coronal T2 fat-saturated MRI labeled to illustrate the medial plantar nerve and adjacent structures.[1]
- General
- Uncommon disease, not well described in the literature
- Symptoms occur due to compression of the medial plantar nerve
- Classically described as burning pain along the medial heel and longitudinal arch
Etiology
- Compression of the medial plantar nerve
- Can occur in either the fibro-osseous tunnel (fascial sling) or the knot of henry
- Typically occurs between the abductor halluces muscle and the knot of Henry [2]
Associated Conditions
- Chronic Ankle Instability
- A history of multiple sprains and chronic instability is common
Pathoanatomy
- Medial Plantar Nerve
- Terminal branch of the Posterior Tibial Nerve[3]
- Motor: innervates the Abductor Hallucis, Flexor Hallucis Brevis, Flexor Digitorum Brevis, and first lumbrical muscles
- Sensory: medial and plantar aspects of the foot, plantar aspect of the 1st–3rd toes, and medial aspect of the 4th toe
Risk Factors
- Sports
- Endurance Running[4]
- Anatomic
- Pes Planus with calcaneovalgus
- Abductor Hallucis hypertrophy
- Hallux Rigidus
- Extrinsic
- Compression due to poorly fitted or new footwear
- Compression from insertional orthoses
Differential Diagnosis
- Fractures & Osseous Disease
- Traumatic/ Acute
- Stress Fractures
- Other Osseous
- Dislocations & Subluxations
- Muscle and Tendon Injuries
- Ligament Injuries
- Plantar Fasciopathy (Plantar Fasciitis)
- Turf Toe
- Plantar Plate Tear
- Spring Ligament Injury
- Neuropathies
- Mortons Neuroma
- Tarsal Tunnel Syndrome
- Joggers Foot (Medial Plantar Nerve)
- Baxters Neuropathy (Lateral Plantar Nerve)
- Arthropathies
- Hallux Rigidus (1st MTPJ OA)
- Gout
- Toenail
- Pediatrics
- Fifth Metatarsal Apophysitis (Iselin's Disease)
- Calcaneal Apophysitis (Sever's Disease)
- Freibergs Disease (Avascular Necrosis of the Metatarsal Head)
Clinical Features
- History
- Physical: Physical Exam Foot
- Palpate for pain along the medial arch [6]
- Pain with Abductor Hallucis palpation, specifically at navicular tuberosity
- Reproduced pain and tingling with nerve percussion and forced passive heel eversion
- Standing on the balls of the feet may worsen symptoms
- Because symptoms are often exercise induced, may be normal unless performed immediately after running
- Special Tests
Evaluation
Radiographs
- Standard Radiographs Foot
- Often normal
- Useful to evaluate foot alignment, degenerative changes
MRI
- Unclear role in diagnosis
- Diagnosis on MRI has been briefly described in literature
- Findings specific to Jogger's Foot have not been reported[7]
- May help exclude
- Space-occupying lesions in the tarsal tunnel
- Radiographically occult midfoot arthritis
- Tendon pathology at the MKH
Ultrasound
- May be useful
- Exact role in diagnosis is unclear
Diagnostic Nerve Block
- May be useful to confirm diagnosis
Classification
- Not applicable
Management
Nonoperative
- Indications
- Most cases
- NSAIDS
- Orthotics
- Rigid foot orthotics should be modified, replaced or removed to avoid compression
- Foot wear modification
- Activity modification
- Running mechanics may need modification
- Physical Therapy
- Hyperpronation may be addressed by medial arch strengthening, kinetic chain rehabilitation
Operative
- Indications
- Refractory to conservative treatment
- Technique
- Surgical release
Rehab and Return to Play
Rehabilitation
- Needs to be updated
Return to Play
- Needs to be updated
Complications and Prognosis
Prognosis
- Unknown
Complications
- Unknown
See Also
- Internal
- External
- Sports Medicine Review Ankle Pain: https://www.sportsmedreview.com/by-joint/ankle/
- Sports Medicine Review Foot Pain: https://www.sportsmedreview.com/by-joint/foot/
References
- ↑ Collins, Mark S., Christin A. Tiegs-Heiden, and Matthew A. Frick. "MRI appearance of jogger’s foot." Skeletal Radiology 49.12 (2020): 1957-1963.
- ↑ Luis Beltran, J. B. (2010). Entrapment Neuropathies III: Lower Limb. Seminars in Musculoskeletal Radiology, 501-511.
- ↑ 3.0 3.1 David Del Toro, A. N. (2018). Guiding Treatment for Foot Pain. Physical Medicine and Rehabilitation Clinics of North America, 783-792
- ↑ Rask M. Medial plantar neuropraxia (Jogger’s foot). Clin Orthop Relat Res. 1978;181:167–70.
- ↑ Ali Alshami, T. S. (2008). A review of plantar heel pain of neural origin: Differential diagnosis and management. Manual Therapy, 103-111
- ↑ Norman Espinosa, G. K. (2020). Peripheral Nerve Entrapment Around the Foot and Ankle. In M. M. Thompson, DeLee Drez & Miller's Orthopaedic Sports Medicine (pp. 1402-1420). Philadelphia: Elsevier.
- ↑ Donovan A, Rosenberg ZS, Cavalcanti CF. MR imaging of entrapment neuropathies of the lower extremity part 2. The knee, leg, ankle and foot. Radiographics. 2010;30:1001–19.
Created by:
Greg Rubin on 19 June 2019 13:15:16
Authors:
Last edited:
4 October 2022 12:41:53
Categories: